Provider Demographics
NPI:1619040243
Name:SIEDLER, HILLARY MIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:HILLARY
Middle Name:MIA
Last Name:SIEDLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1814
Mailing Address - Street 2:
Mailing Address - City:ENKA
Mailing Address - State:NC
Mailing Address - Zip Code:28728-1814
Mailing Address - Country:US
Mailing Address - Phone:828-230-7006
Mailing Address - Fax:888-974-0987
Practice Address - Street 1:206 MERRIMON AVE
Practice Address - Street 2:STE 4
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1230
Practice Address - Country:US
Practice Address - Phone:828-230-7006
Practice Address - Fax:888-974-0987
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2697103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC045XYOtherBCBS
NC6000376Medicaid
NC2492678AMedicare ID - Type Unspecified